Health Information and Tools >  Dialysis: Exercise for your new AV fistula

Main Content

Dialysis: Exercise for your new AV fistula


Exercise for your new AV fistula

What is a fistula?

A fistula is made when an artery and a nearby vein are sewn together. This makes a vein bigger and stronger.

What is a fistula used for?

A fistula is needed for hemodialysis. It’s used to send your blood to the hemodialysis machine and back to your body after your blood is cleaned.

Two needles are put into the fistula in your arm each time you have a hemodialysis treatment.

Where is the fistula and what does it look and feel like?

The fistula is under your skin so you may not be able to see it at first. You should feel a vibration when you put your fingers over the fistula. This is called a “thrill” or “buzz”. Over time, the vein gets bigger and you’ll be able to see it.

Why do you need to exercise your arm that has the fistula?

Exercise gets blood flowing to your arm. This may make:

  • the fistula bigger and stronger so it’s easier to feel and put a needle into it
  • the muscles around the fistula firmer to support the fistula

When should you start exercising your arm?

It’s important to exercise your arm both before and after your surgery.

Before surgery

Start the exercises as soon as you find out you need a fistula. This may make the vein bigger which helps your fistula to develop.

After surgery

Start doing the exercises 2 weeks after surgery when the areas on the skin that were cut (incision sites) have healed.

When should I stop exercising?

Keep doing these exercises until your nurse tells you to stop. You should stop doing the exercises and call your access nurse or dialysis unit if:

  • your fistula becomes red, painful, swollen, or is leaking (has a discharge)
  • the fistula area hurts
  • the “thrill” changes or is missing
  • your arm or hand on the same side of the body as the fistula gets cold, pale, or blue
  • your fistula feels warm when you touch it

Fistula exercises

Lower arm fistula: Exercise 1

  • Hold a soft ball or rolled wash cloth in the hand that is the same side as the fistula.
  • Let your arm hang down beside your body.
  • Squeeze the ball or wash cloth gently and then relax.
  • Repeat the squeezing and relaxing for 5 minutes.
  • Do this exercise 3 to 4 times each day.

Lower arm fistula: Exercise 2

Put your lower arm (with the fistula) and wrist on a flat surface with the palm of your hand up. Your wrist should be at the edge of the surface.

  • Slowly curl your wrist up and down.
  • You can do this exercise with a can of soup or a small 1-pound weight.
  • Do this exercise 4 times a day for 5 minutes.

Upper arm Fistula: Exercise 1

  • Hold a 2-pound weight in the hand that is on the same side as your fistula.
  • Start with your arm down at your side and slowly curl your arm.
  • Do this exercise 4 times a day for 5 minutes.

To see this information online and learn more, visit


Related to Exercise for Fistula

For 24/7 nurse advice and general health information call Health Link at 811.

Current as of: November 13, 2020

Author: Kidney Care Strategic Clinical Network, Alberta Health Services

This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.